65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

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정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

납 노출 근로자들에서 ALAD 및 VDR의 다형질성이 조혈기능 지표에 미치는 영향

이성수,김남수,김진호,김용배,황보영,김화성,안규동,이병국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objectives: This study was conducted with new workers who entered lead industries from 1992 to 2001 to evaluate the genetic susceptibility of ALAD (δ-aminolevulinic acid dehydratase) and VDR (vitamin D receptor) gene on health effect of lead exposure. Methods: Among the subjects of the database of lead industries at the Soonchunhyang University Institute of Industrial Medicine, only new workers were selected for this study. The total of eligible workers for this category was 3,540 workers, including non lead exposed workers of same lead industries. From stored blood in specimen bank of Soonchunhyang University, genotype of ALAD and VDR were measured using PCR method. Variables for this study were blood lead as an index of lead exposure, ZPP (zinc protoporphyrin in blood), urine ALA (δ-aminolevulinic acid), and hemoglobin as an index of hematopoietic effect of lead. Information on sex, job duration, and weight were collected for personal information. The data were analyzed using SAS (version 8.2) with descriptive analysis of t-test and multiple regression analysis. Results: Among 3,540 new employed study subjects during period of 1992-2001, 3,204 workers (90.5%) had ALAD genotype 1-1, while 336 workers (9.5%) had variant type of ALAD (1-2 or 2-2). For VDR genotype, 2,903 workers (89.7%) out of total tested 3,238 workers were belonged to type bb and 335 workers (10.5%) were type bB or BB. The distribution of genotype of ALAD and VDR were not different according to the job duration in male workers, but were different in female workers. The effect of ALAD and VDR genotype on blood lead were positively significant in the analysis of all cumulative data of new employed workers for 10 years. The effect of VDR genotype on blood lead were stronger than that of ALAD While the variant ALAD gene made decrease of mean ZPP and ALA in urine after controlling for blood lead and other covariate, the variant VDR gene made increased the mean ZPP and ALA in urine in all cumulative data analysis and cross sectional analysis by job duration. For hemoglobin, ALAD and VDR genotype did not affect the mean value. Conclusions: From the above our results, we found that ALAD and VDR genotype exerted significant effect in various way. We confirmed that the finding of a cross sectional study of protective effect of variant ALAD on the effect blood lead on blood ZPP in our retrospective study design. It was found that VDR did not exert protective effect for lead exposure as the variant ALAD did.

SrCI_2:Eu^2+ 형광체의 광발광 및 광자극발광 특성

도시홍,서효진,김영국,김도성,김성환,김찬중,이병화,김완,강희동 한국센서학회 2002 센서학회지 Vol.11 No.6

고상반응법으로 SrCl_2:Eu^2+ 형광체를 제작하고, 제작한 형광체의 광자극발광과 광발광 특성을 조사하였다. SrCl_2:Eu^2+ 형광체와 광발광 및 광자극발광은 Eu^2+ 의 5d->4f 천이에 기인되었으며, 355 nm의 광으로 여기시켰을 때 광자극발광과 광발광 스펙트럼의 파장범위는 모두 380~440nm이었고, 피이크 파장은 407nm이었다. SrCl_2:Eu^2+형광체의 선량의존성은 2.5 mGy~200mGy영역에서 우수한 선형성을 나타내었으며, 상온에서 광자극발광의 fading은 20분에 60%이었다. SrCl_2:Eu^2+ phosphors were prepared by the solid phase reaction method, and their photostimulated luminescence(PSL) and photoluminescence(PL) characteristics were investigated. The PSL and PL peak of the SrCl_2:Eu^2+ phosphors are due to the 5d->4f transition of Eu^2+ ions in phosphors. The PSL and PL spectrum obtained by the 355 nm exitation was observed in 380~440 nm region with the peak at 407 nm. The dose response of the PSL phosphors were linear within 2.5 mGy ~ 200 mGy of 100kV X-ray. The fading of the phosphors at room temperature was approximately 60% after 20 min.

방사선치료 조사영역 내에 발생한 설암 환자에서 입체조형방사선치료 경험 : 증례보고

조문준,장지영,김기환,김병국,송창준,김준상,김재성 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Objectives : We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods : A 64-year-old male patient was diagnosed with T4NOMO supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2NOMO. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from 7×6.4 to 8×8㎠, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results : In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion : Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.

방사선치료 조사영역 내에 발생한 설암 환자에서 입체조형방사선치료 경험 : 증례보고

조문준,장지영,김기환,김병국,송창준,김준상,김재성 충남대학교 암공동연구소 2003 암공동연구소 업적집 Vol.3 No.

Objectives : We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods : A 64-year-old male patient was diagnosed with T4NOMO supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2NOMO. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from 7×6.4 to 8×8㎠, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results : In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion : Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.

BaFBr:Eu^2+ 형광체의 열발광 및 광자극발광 특성

도시홍,서효진,강갑중,김영국,김도성,김성환,김찬중,이병화,김완,강희동 한국센서학회 2002 센서학회지 Vol.11 No.5

BaFBr:Eu^2+ 형광체를 제조하고, 이 형광체의 열발광 특성과 광자극발광 특성을 조사하였다. 이 형광체의 열발광 g1ow 피이크 온도는 352K와 448K였으며, 주 피이크(352K)에 관여하는 트랩의 활성화에너지는 약 0.96eV이었다. 또한 이 형광체의 광자극발광 스펙트럼의 파장범위는 350~450nm 사이였으며, 광자극발광에 기여하는 트랩의 활성화에너지는 약 0.98eV이었다. 열발광트랩과 광자극발광 트랩의 활성화에너지는 실험오차 내에서 일치하였다. BaFBr:Eu^2+ phosphors were prepared, and the thermoluminescence(TL) and photostimulatedluminescence(PSL) of the prepared phosphors were measured. Two glow peaks around 352 and 448 K are observed for x-ray irradiated BaFBr:Eu^2+ phosphors, and the activation energy of the main glow peak(352 K) was about 0.96 eV. The spectral range of the PSL was 350 ~450 nm, and the activation energy of the trap giving rise to PSL was about 0.98 eV. The activation energy of the traps giving rise to TL is agreed to those giving rise to PSL within experimental error.

결핵성 경부임파선염에 대한 임상적 고찰

김병국,이범식 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Although the incidence of tuberculosis has decreased recently, tuberculous cervical lymphadenitis is one of the common cause of neck mass in Korea. We performed a retrospective review for 61 cases with tuberculous cervical lymphadenitis, which were confirmed histopathologically in Department of Otolaryngology, ChungnamNational University Hospital between Jan. 1992 and Oct. 1995. The results were as follows : 1) Most cases were in the age group of 20-29 years old and the sex ratio of male to female was 1 : 1.08 2) The physical findings were painless lymphadenopathy in 35 cases (57.3%), hard nodes in 45 cases (73.8%) and mobile node in 45 cases (73.7%). 3) There were multiple lymphadenopathy in 43 cases (70.5%) and was solitary one in 18 cases (29.5%). Among 43 cases with multiple lymphadenopathy, 7 cases (11.5%) were bilateral. 4) The location of lymphadenopathy was posterior neck triangle in 37 cases (60.7%), anterior neck triangle in 13 cases (21.3%) and both triangle in 11 cases (18%). 5) The size of mass was smaller than 3cm in 38 cases (62.2%) and bigger than 3cm in 23 cases (37.8%). 6) The time interval from the onset of symptom to first visit was less than 5 months in 48 cases (78.7%), 6 months to 12 months in 8 cases (13.1%), over than 12 months in 5 cases (8.2%). 7) Associated pulmonary tuberculosis was seen in 19 cases (31.1%). 8) The excision and antituberculous medication were performed in 49 cases (80.3%) Incision and antituberculous medication were performed in 12 cases (19.7%). 9) The duration of antituberculous medication was 6 months in 7 cases (11.5%), 6 months to 12 9) The duration of antituberculous medication was 6 months in 7 cases (11.5%), 6 months to 12 months in 29 cases (47.5%), 18 months in 1 case (1.6%). 10) There was no palpable neck mass in 26 cases (53.1%), decreased mass in 17 cases (34.7%) stationary mass in 5 cases (10.2%), and increased mass in 1 case (2.0%) after or during the treatment.

연취급 근로자들의 사회 심리적 스트레스가 연노출 수준에 미치는 영향

김용배,황보영,김화성,이성수,안규동,이병국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Objectives : This study was carried out to assess psychosocial distress of lead workers and to examine the effect of psychosocial distress on lead exposure indices. Methods : The study design was cross-sectional and research subjects were 246 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psycosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), δ-aminolevulinic acid in urine(ALAU) were selected as indicators of lead exposure. Results : The crude odds ratio of group whose PbB was 20-39 ㎍/㎗ was 3.475(95% CI : 1.243-6.404) and that of group whose PbB was above 40 ㎍/㎗ was 7.586(95% CI : 1.487-15.611). The odds ratio of each group adjusted age, wages, job characteristics, social support, smoking and alcohol drinking habit were still significant. Conclusions : Our results supported the association between lead exposure and psychosocial distress. The inclusion of psychosocial distress measurement as a special health examination for lead workers is highly recommended for the effective prevention of stress in lead workers.

아급성 연폭로시의 연흡수 지표들의 상호관련성

김대기,이성수,안규동,이병국 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

In order to investigate the interrelationship among lead exposure indices in subacute lead exposure, 20 rabbits were equally divided into four groups of 5 rabbits each and lead acetate was administered subcutaneously everyday for 52 days with doses of 25 ug/kg/day (group Ⅰ), 50 ug/kg/day (group Ⅱ), 100 ug/kg/day (group Ⅲ), and 200 ug/kg/day (group Ⅳ) respectively. The parameters chosen for lead exposure indices were blood lead(PBB), urine lead(PBU), zinc protoprophyrin in whole blood (ZPP) and delta-aminolevulinic acid dehydratase activity(ALAD). Each parameter was checked 17 times throughout the study period. The results obtained were as follows: 1. The highest correlation with injection dose was found with blood lead and followed by urine lead. While log-transformation of ALAD(LOGALAD) had high correlation with injection dose in all 4 groups, the correlation coefficient between injection dose and log-transformation of ZPP(LOGZPP) were steadily increased by the intensity of lead exposure. 2. There were significant correlations between blood lead and urine lead in all 4 groups with correlation coefficient over r=0.90. The correlation between blood lead and LOGALAD were significantly high in all 4 group with no difference of correlation coefficient. But the correlation coefficient between blood lead and LOGZPP were steadily increased by the intensity of lead exposure. 3. While injection dose were significant correlated with blood lead and urine lead after 1st day of lead injection, significant correlation between injection dose with LOGZPP and LOGALAD were observed after 21th day of injection and 14th day of injection respectively. 4. While in simple linear regression analysis with injection dose as independent variable and blood lead or urine lead as dependent variables, there were slow increase of slope by the intensity of lead exposure, those with injection dose as independent variable and LOGZPP or LOGALAD, there were more steep increase of slope by the intensity of lead exposure.